LoDoCo2: Colchicine benefits consistent regardless of ACS history, timing
In patients with chronic coronary disease, the beneficial effects of colchicine were consistent regardless of history of ACS and time of treatment following ACS, according to new data from the LoDoCo2 trial.
As Healio previously reported, in the main results of LoDoCo2, in patients with chronic coronary syndrome on optimal medical therapy, colchicine 0.5 mg per day reduced CV events by 31% compared with placebo. For the present analysis of 5,522 patients, Tjerk S.J. Opstal, MD, cardiologist at Radboud University Medical Center, Nijmegen, the Netherlands, and colleagues assessed whether the treatment effect of colchicine in LoDoCo2 varied by ACS history.
Participants were stratified into four groups: those with no prior ACS; those with recent ACS, defined as 6 to 24 months; those with remote ACS, defined as 2 to 7 years; and those with very remote ACS, defined as more than 7 years.
According to the researchers, the primary endpoint of CV death, spontaneous MI, ischemic stroke or ischemia-driven coronary revascularization favored colchicine over placebo in all four groups (P for interaction = .59):
- No prior ACS: 2.8 events per 100 person-years vs. 3.4 events per 100 person-years; HR = 0.81; 95% CI, 0.52-1.27;
- Recent ACS: 2.4 events per 100 person-years vs. 3.3 events per 100 person-years; HR = 0.75; 95% CI, 0.51-1.1;
- Remote ACS: 1.8 events per 100 person-years vs. 3.2 events per 100 person-years; HR = 0.55; 95% CI, 0.37-0.82; and
- Very remote ACS: 3 events per 100 person-years vs. 4.3 events per 100 person-years; HR = 0.7; 95% CI, 0.51-0.96.
In a related editorial, Jean-Claude Tardif, MD, director of the Montreal Heart Institute Research Center and professor of medicine at the Université de Montréal, and Guillaume Marquis-Gravel, MD, MSc, assistant professor of medicine at the Université de Montréal, wrote that “These data support the evolving story showing benefits of colchicine therapy in patients with coronary artery disease, including those presenting with acute coronary syndromes.
“In light of the positive results from LoDoCo2, COLCOT, and meta-analyses; its good tolerability profile; and cost-effectiveness, inflammation reduction with low-dose colchicine should be considered to treat patients with coronary disease in the absence of severe renal dysfunction,” Tardif and Marquis-Gravel wrote.
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